CDC Technology Advances Promise Better Valley Fever Detection

New technology could reveal the microscopic, sometimes deadly spores that cause valley fever that currently float in the air undetected.

The U.S. Centers for Disease Control and Prevention (CDC) is developing a sensor that can detect levels of the cocci fungus in the air and soil, said Christopher Braden, deputy director of the CDC’s National Center for Emerging Zoonotic Infectious Diseases branch. The agency has been working on the technology for three years, and Braden is hopeful the sensors could be moved into wider use over the next few years.

“As far as we know, we’re the first ones who have been able to find the right combination of preparing the sample and the molecular test itself to be able to detect the organism in different soil and air samples,” Braden said.

The CDC has adapted vacuum devices typically used by the Occupational Safety and Health Administration to detect levels of hazardous materials in workplaces. These devices are placed in areas with dry soil, where they pull in air at regular intervals and test it for the DNA of the fungus. The level of fungal spores in the air is then sent to a central computer.

If the technology could be deployed throughout endemic regions in the Southwestern United States, it could provide a breakthrough in awareness and prevention efforts, local health officials said.

Devices could lead to warning system

Credit THE CENTER FOR HEALTH JOURNALISM COLLABORATIVE

As it stands, health officials can only warn people to take caution on windy days, or when the air quality forecast hits unhealthy levels.

“It’ll be a huge tool to put in our tool box,” said Kirt Emery, a Kern County Department of Public Health Services epidemiologist, who quickly rattled off all the ways that technology could prevent cocci’s spread in the nation’s most impacted regions.

The devices could confirm whether cocci is stirred up by construction and agriculture, as experts have for years suspected. During storms, a color-coded air quality alert could be issued just for cocci. If the technology is advanced enough, fungus from Sharktooth Hill, a valley fever hotspot, could be traced to see how far it travels on windy days. Eventually, a mass alert could be developed that pings cellphones when people enter certain regions on high-risk days.

The technology could also shorten the time lag between when health officials realize there’s an outbreak and when they warn the public, said John Galgiani, director of the Valley Fever Center for Excellence at the University of Arizona.

The Kern County Department of Public Health Services, for example, issued a public health warning in September after noticing an increase in lab test requests for valley fever. Typically, lab test requests come in long after individuals inhale fungal spores.

Sensors could redraw valley fever map

CDC officials have been testing the devices to detect cocci in environments where they know it already exists. They also are using the tool to determine whether the fungus lives in environments they suspect could be endemic, such as parts of Oregon and Washington, Braden said.

The new technology can also take away some of the guesswork about whether infected people contracted valley fever while traveling, only to be diagnosed later in their home states.

“You can pinpoint and say we’ve got hotspots in other areas in the United States, then come back with the awareness campaign to make sure people get treated,” Braden said.

Researchers at the University of California Merced’s Health Sciences Research Institute attempted a similar project, developing a drone that would sniff out cocci in the air. It hasn’t seen as much success as the CDC’s vacuum devices.

“We are still playing around with the samples, but it basically comes down to the fact that the density of microbes in the air obviously isn't very high, so you need to sample a lot of air to get enough microbial material,” said Michael Beman, an environmental scientist at UC Merced. “Small drones may not ultimately be that great for this.”

Kerry Klein of Valley Public Radio contributed to this report.

This project results from a new venture – the Center for Health Journalism Collaborative – which currently involves the Bakersfield Californian, Radio Bilingüe in Fresno, Valley Public Radio in Fresno and Bakersfield, Vida en el Valle in Fresno, the Voice of OC in Santa Ana, the Arizona Daily Star in Tucson, La Estrella de Tucsón and CenterforHealthJournalism.org. The collaborative is an initiative of the Center for Health Journalism at the University of Southern California’s Annenberg School for Communication and Journalism.

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Valley fever has long been a major health concern for people who live in the San Joaquin Valley. A fungus that grows in the soil can become airborne. If inhaled it can cause serious health issues, even death in some cases, though most people who contract the disease have a mild case, and they don’t even know they’ve had it. Now cases of the disease are up significantly in Kern County and some say it is connected to California's weather patterns.

Bakersfield’s Kern Medical has selected to work with the National Institutes of Health and the Centers for Disease Control on a new clinical trial for valley fever. House Majority Leader Kevin McCarthy made the announcement Thursday at the hospital. The study aims to learn more about both diagnosing and treating the disease.

Valley Fever is caused by a fungus that grows in the soil throughout the southwest, including the Southern San Joaquin Valley. If inhaled it can cause serious health problems, those most people never know they have been infected.

California health experts are surprised that the incidence of Valley Fever has gone down during the drought. The fungal infection is commonly spread in arid, dusty conditions. But, even though the state is drier, the number of cases continues to drop. Capital Public Radio's Lesley McClurg has the story.

Valley Fever peaked in 2011 with more than 5,000 cases in California. Last year there were fewer than half that. Dr. James Watt is the Chief of the Division of Communicable Diseases for the California Department of Public Health.

When a punishing drought besieged California in the late 1980s, relief came with 30 days of rain in 1991 — dubbed the March Miracle because of how it revived the state’s agricultural economy.

Those significant swings in the weather may have had another consequence, though. The next year, Kern County health officials counted more cases of valley fever than ever before, with roughly 3,342 diagnoses and 25 deaths. By contrast, a decade earlier in 1982, fewer than 200 people were diagnosed with the disease and seven died.

The National Institutes of Health and the Centers for Disease Control and Prevention will undertake a clinical trial to learn more about valley fever, agency leaders announced Monday at the start of a two-day symposium on valley fever, hosted by Bakersfield Congressman Kevin McCarthy.

"There are so many things we don't know about valley fever, and the best way to get the answers is to run a clinical trial," said National Institutes of Health director Dr. Francis Collins.